Limited findings, lack of diagnostic accuracy and treatment efficacy data, and heterogeneity of assessments and interventions precluded robust evaluation of clinical implications for telepractice equivalence and the broader area of telepractice efficacy. Future research is needed that will build upon current knowledge through replication. In addition, further evaluation at the impairment and activity limitation/participation restriction levels is needed.

Thickened liquids are a common treatment for dysphagia; however, little is known about their effects in children. The aim of this systematic review was to summarize the state and quality of evidence for the use of thickened liquids on swallowing physiology, oral feeding, weight gain/growth, hydration, and pulmonary health outcomes in children with dysphagia. Another aim was to identify any increased occurrence of adverse effects that may be associated with their use in all children, not just those with dysphagia. A total of 24 electronic databases were systematically searched. Articles meeting the inclusion criteria were evaluated for methodological quality by 2 reviewers and vetted by a third. In total, 22 studies were included. Six studies, with significant methodological limitations, examined the effects of thickened liquids on swallowing physiology or pulmonary health outcomes and reported mixed findings. Sixteen studies examined adverse effects and indicated that among a select pediatric population with gastroesophageal reflux, no significant increase in the rate of adverse effects from the use of thickened liquids was noted. Results of this review highlight the insufficient evidence base for this popular treatment option. Additional experimental research is warranted to understand the efficacy and effectiveness of thickened liquid use in the pediatric population.

Purpose The purpose of this evidence-based systematic review was to evaluate the efficacy of digital noise reduction and directional microphones for outcome measures of audibility, speech recognition, speech and language, and self- or parent-report in pediatric hearing aid users. Method The authors searched 26 databases for experimental studies published after 1980 addressing one or more clinical questions and meeting all inclusion criteria. The authors evaluated studies for methodological quality and reported or calculated p values and effect sizes when possible. Results A systematic search of the literature resulted in the inclusion of 4 digital noise reduction and 7 directional microphone studies (in 9 journal articles) that addressed speech recognition, speech and language, and/or self-or parent-report outcomes. No digital noise reduction or directional microphone studies addressed audibility outcomes. Conclusions On the basis of a moderate level of evidence, digital noise reduction was not found to improve or degrade speech understanding. Additional research is needed before conclusions can be drawn regarding the impact of digital noise reduction on important speech, language, hearing, and satisfaction outcomes. Moderate evidence also indicates that directional microphones resulted in improved speech recognition in controlled optimal settings; however, additional research is needed to determine the effectiveness of directional microphones in actual everyday listening environments.